中国人ACEI/D基因多态性与高血压患者ACEI降压效果的meta分析  

ACE I/D gene polymorphism and antihypertensive effect of ACEI in Chinese:a meta-analysis

作　　者：王佐广[1] 彭晓云[2] 李丽立[1] 温绍君[1] 刘洁琳[1] 刘雅[1] 刘阔[1] 严山[1] 楼煜清[1] 文杰[1] 吴兆苏[3] 

机构地区：[1]首都医科大学附属北京安贞医院高血压研究室,北京100029 [2]中国科学院西北高原生物研究所,青海西宁810008 [3]首都医科大学附属北京安贞医院流行病学研究室,北京100029

出　　处：《中国现代医学杂志》2010年第23期3566-3570,共5页China Journal of Modern Medicine

基　　金：北京市自然科学基金资助(No:7102045);国家"863"课题资助(No:2008AA02Z441)

摘　　要：目的探讨原发性高血压患者血管紧张素转化酶(ACE)I/D基因多态性对血管紧张素转化酶抑制剂(ACEI)类药物治疗的疗效反应。方法应用meta分析有关中国原发性高血压患者进行ACEI类药物治疗与ACE I/D基因多态性相关性的随机对照研究11项。通过综合定量分析,用固定/随机效应模型(D～L法),对DD/DI/II基因型与差值收缩压(dSBP)和差值舒张压(dDBP)进行比较。结果 DD/DI、DD/II和DI/II的收缩压加权均数差及95%可信区间分别为-3.91[-7.28,-0.55]、-6.78[-10.85,-2.70]和-1.21[-2.05,-0.36],P值分别为0.02、0.001和0.005;DD/DI、DD/II和DI/II的舒张压加权均数差及95%可信区间分别为-1.03[-2.32,0.27]、-3.03[-5.17,-0.89]、-1.44[-2.76,-0.12],P值分别为0.12、0.005和0.03。结论 DI基因型、D等位基因的患者对ACEI类降压药物具有更好的疗效反应。【Objective】 To explore the correlation between the therapeutic effect of angiotensin-converting enzyme inhibitor（ACEI） and the genotype of ACE I/D in essential hypertensive（EHP） patients.【Methods】 Using meta analysis methods,11 random and controlled studies which focused on the effect of ACEI and genotype of ACE gene in Chinese hypertensive patients were carried out.Random effect model and fixed effect model（D～L method） were selected to calculate the weighted mean difference（WMD） and its corresponding 95% confidence interval（95%CI） of DD/DI/II genotypes and related differential SBP（dSBP） and DBP（dDBP）.【Results】 The WMD and 95%CI of DD/DI,DD/II and DI/II of dSBP were-3.91[-7.28,-0.55],-6.78[-10.85,-2.70],-1.21[-2.05,-0.36];P value were 0.02,0.001 and 0.005,respectively.The WMD and 95% CI of DD/DI,DD/II and DI/II of dDBP were-1.03[-2.32,0.27],-3.03[-5.17,-0.89] and-1.44[-2.76,-0.12];P value were 0.12,0.005 and 0.03,respectively.【Conclusion】 Chinese EHP patients with DI genotype and D allele of ACE may be more sensitive to ACEI antihypertensive drugs than others.

关 键 词：血管紧张素转化酶 基因多态性 血管紧张素转化酶抑制剂 原发性高血压 META分析 

分 类 号：R78[医药卫生—口腔医学]